tax credits for perfectly valid reasons, at least in my opinion. and then it is up to do to try to make it work. and one of them related to tax credits for energy efficient windows, doors and insulation and geothermal heat pumps and solar heaters i probably voted for it. it sounded like a good idea. for tax year 2000 when they claimed more than $5.8 million of the energy credit which were included in the 2009 economic stimulus recovery act. based on the review of the statistically valid sample of the 150 tax returns the treasury inspector general for the tax administration was not able to confirm who ownership for 30% of that sample, 45 of the taxpayers, which of course is required to claim the credit. so there is at least a question going forward as to whether

these for 30% of the people who claim the money were eligible for it. in addition, this inspector general identified 362 and eligible individuals who were allowed to erroneously claimed $404,570 of residential energy credits on their tax returns. ..

when people want to give incentives and when there was a major economic melt down across the globe, people quickly used the tax system to push a lot of money out, to help stabilize economies. the tax system is sufficient and may be an interaction that can happen every year with most americans. when we have time, we can set up filters, find out whether there is potential leakage find out what data we can get in to get through an electronically filed returns and set up screens and filters and we do that. and so, for instance, the report you reference, it happened very quickly when we were trying to do some things. we set out a set of filters. it is generally viable service. we put more filters in place while they're having dialogue with that report.

some leakage occurred, which would like to have zero leakage with any credits because really going to because really going to be able to screen and follow up with a certain amount. but we do do follow-ups. things happen quickly sometimes more refunds go with a terrific and we have an audit program of the audit and find out what they will follow up in clothes. make no mistake. i think you're getting and sophisticated filters and stuff the vast majority of going out. the tax system is built on voluntary compliance and it's got to get balance right between the three friends to people and he's been spent or them to spend an block in the bad ones, there is going to be some leakage.

our ballistic at the balance right, to hear the leakage as much as we can. >> senator brandt, just bear with me. i want to answer questions. and the most egregious cases, when someone is claiming their homeowner title ii these critics and effect are not convinced that they clearly misrepresented the legibility for programs. not a math error, clear misrepresentation. in those cases we need to take them come is a follow-up in terms of penalties, fines, prosecution? >> penalties, gas, fines , yes. pgh prosecutions we have limited prosecutorial resources. resources and places that are the most long-term deterrence. our criminal investigation is things around, prepare your

side, identity theft fraud and very specific tax fraud. we try to allocate resources. so the answer is yes. a lot of times you'll see a scheme where one person is this a bunch of false claims and come off as a return, comes back. usually an individual with a thousand dollars credit for themselves fraudulently used it will be find it much more of a simple context in a criminal context. the bigger the crime, the more it happens and i see no partnership at the justice department and local u.s. attorneys. >> i've talked about this specific credit. last question here. if you could take a look at the overall landscape, which we find find the most proud in terms of claiming that they are not entitled to. >> you know, the tax code is incredibly complex. there's a fair amount of

noncompliance. some of it is confusion. some of it is fraud. the police is refocused, which is really think that most leverages for the texas and to make sure we protect the fifth is overseas and off shore tax evasion, people parking overseas, complexity is where people hate them push the envelope. we've been focused around preparer fraud because we think it's a big point of leverage if one preparer gets 1000 taxpayers and encourages them to do something fraudulent, a lot of time to taxpayers or expect to become like that down as the big link in the system. refundable credit, places where you can get a tax credit that's large defined fried. we did a lot of focus on first-time home buyer, where is the big refundable credit for this temporary, quick. we put a lot of effort there around both civil and criminal

follow-up in this set of credits that you talked about is where we put a lot of effort. >> thank you. thank you, senator graham. >> commissioner, following that line of questioning, how often is that the irs finds the fraud as compared to an inspector general's report tory gao report requested by congress? how actively engaged in how successful are you impaired enough the problem without some other agency pointing out the fraud with the challenge? >> so, every tax return is three spree. it is our fraud filters and it looks fuller returns that have the same addresses. 100 returns at the same addresses. big change in income. you know, not having the proper documentation attached for information in the return.

preset filters intolerances frankly based on resources. a lot of these are in dacia that we need to follow up on and so we have units. this little units that call employers can say is this income accurate? and then it takes such a criminal who develop schemes and beats her criminal prosecution. what i would say is gao, inspect your general, congressional oversight really helps us by focusing on places where they cartoonishly cage. i don't think there's been an instance since i've been there where people have found more fraud in their investigation can be factually wrong. to see these cents anonymous to, ice cream filters take out between what 2 million tax returns the year that we do follow up on. we block every year and reject 2 million returns to have

duplicate ssn, dependents or individuals. and sometimes as a transcription error, but sometimes it is some of the trying to defraud the system. in utc alone we protect $4 billion annually through our enforcement efforts and blocking refunds go out. so we've got incredibly active program name. do you know, it's helpful to the people overseeing the program, finding that there's too much leakage and the continual evolution and take a nap. frankly, the real fraudster art semifamous and her assistants and lewis have to be one step ahead. >> two examples that chairman durbin indicated that the prisoner example is something you would've no before we read about in the paper? shura, we've had extensive conversations. the root word -- let a counterintuitive to a average american set of prisoner can get

a tax refund. >> i think the reality is some prisoners can't get tax refunds. we need to do screening. if you actually look at the report does say there have been more, they also show we been screening more and blocking board and identifying mark. the gross volume every time this year, the numbers, percentages were taught, the amount we filtered or protect them a lot more money. as a fraction, moore was going out. >> you talked about the philemon savings that come from the successful program. first of all, how much more potential is there for savings? is the more opportunity for more defiling expected? secondly, you talk about the 190 million in efficiency savings reductions in nonrecurring committees.

what does that mean in the budget and appropriations process? >> so, keyfile, just to tell you what we've done, we've shut down five of our 10 processing centers over the last six years. hasn't been popular with folks for those processing centers for, but we've been very clearly reaping the savings that he finally and for right now we plan with a series of shutdowns, but certainly we're going to look to be ignored. 75% individuals defiling. 20 years from now, the irs won't take any paper. we still take some paper. i am hoping the percentage will just keep going up in madison great working with the with individuals connected to security very seriously and no one has been worried with

returns there's going to be any leakage. since i came here and for every budget for the last two years that i've submitted, we've always submitted financial stadiums. i believe this ahead of the agency do you can always find efficiencies and you've always got to be looking at corporation , stopping operations that don't make sense if you can reinvest in the future. this year, the 190 million are savings turned keyfile, repeat cutting down or processing operations reducing i.t. infrastructure. we been through a capable maturity models which is standard track is what they been stockmarkets and the computer systems, where you bring in an

standardize your processes across your whole i.t. infrastructures. you are on standard ways of documenting, outside of the thing of software engineering that action will come in and do random audits to see. is that we've been promising for the last two years 75 million a year at the more efficient and more standardized and cheap to elegy officers signed up for the saving. as i missing here you just ask act will keep doing savings than just corporations. it actually increases it will save you money. this year we didn't send out any 1040 forms. as the family we crossed a threshold. within in the past if he filed for the 1040, who attenuate 1040. i thought that was a self-fulfilling prophecy. we're not going to spend $10 million printing and sending

out those who prepare contracts. this is just a series of issues. to be honest, as the chairman said, we've been under acr because their sensation in teams like rent and other things an effective cut them into an aggressive cost cutting this year as well, and he on the things listed in our 2011 budget as cost savings. the immaculate across $190 million more in your appropriations request and budget request before the savings. >> correct. >> what percentage of american individuals filed the return with the assistance of a professional preparer? >> about 60% was last year. that number is actually going up. and another 20% use prepackaged software. 80% are using them sort of -- some of the professional realm to help them with their tax return. >> at e.u. summit in the film,

is not an automatic defile or their prepares on paper? >> so, one of the things it becomes one of our processing centers, which drives me crazy, when i walk around us have it printed after the attacks are turned on the computer and send it to us that the people they're tacky is back and after it's already been type to influence. you know, there is a 10% error. through their reducing, but that's how you transcription errors. it's incredibly inefficient. last year, congress actually passed in the final man date for preparers. we've been seizing again. gives it ready to have any preparer who files can return to the file. this year we started preparers with 100 returns. you know, that the thing about keyfile and i think we get this rate over the years is the only guy to mandate once we really

had meant some and i must everyone we could convince voluntary be to cendant had involuntarily. really increased use on others to mandate that says very prepare using software unique keyfile blessed to get a waiver from your client to really wants to send it in on paper. >> chairman, at other questions. >> so, we are in this debate here about our deficit in how we can come up with savings of $4 trillion over 10 years of roughly 400 alien dollars a year, either intended spending so that is kind of the standard greasing. save 400 billion. it is estimated $345 billion in federal taxes go and collected, a noncompliance rate of 16.3%. this growth problem illustrates an enormous untapped resource of

federal revenue, which could go a long way to dealing with their shortfalls in our deficit. most of the tax gap maternity 5 billion out of 345 is attributable to underreporting of tax liability. 197 billion on thoughts from individual income taxpayers. underreporting can be the result of understated income, improper reductions, overstay reduction expenses and erroneously claimed credit. so we went through an exercise here in the affordable health care and decided one way we can capture some of these uncollected tax revenues when it came to small businesses was to have more reporting from them, more 1090 nines reflect in their business committee. well, naturally there was huge pushback from the business community, seymore paperwork, thank you, washington. so we packed track walked away

from that and said we won't take them in the system. so i want to ask you a pretty obvious question with a pretty obvious answer insured. is there a way to address this tax gap without more reporting, more regulation and more disclosure? >> so, our statistics basically show we have information with porting and withholding. so the average american's paycheck is withheld and the employer since then the taxes and they get a refund. you're over 99% compliance. or you have some information reporting, mortgage interest, deduction, 1090 nines reporting for interest on bank account, you know, that kind of thing is that 95, 96% compliance. where you have no information with porting from a cash

economy, businesses, you know, compliance -- it's hard to do the studies. they are by their nature and accurate. recoded to research, to some statistically select did samples, et cetera. you get 50%, 60% compliance, 70% compliance. to really answer that please are his leverages information reporting. as you said, we separate tax system is a voluntary tax system, we are fully forthcoming with the government, report which you know we keep an eye on things. the week in a broad coverage is having a third party to information reporting. it's the only efficient way to go in the tax gap. because it affects a lot of people at the tax code, it becomes politically unpopular like he said that the 1090 nines reporting. i fully understand both politics realities around small businesses and what people are

trying to do cheers and so it is very tough. there is an economist who spent a lot of time to set the thing to remember about the tax gap if it is like deep shale oil preserved. this is not just minicity mutates easily tap. we have in many ways tapped the money. we actually have a very high tax tax compliance rate. there's only five countries to study the tax gap and we are as high as any of them. the way to go at the tax cuts is better information reporting. but it brings with it some burden. i do think there's just basically said offender information technology to become more ubiquitous. it is lower cost and easier for people to the reporting. a good example is history we are implementing the credit card reporting, where we would get from credit card processors and

people like paypal gross receipts that were paid into businesses that's not a direct match because some industries have high credit card receipts. some industries have lower credit card receipts. we will look at the statistics and it will be another factor reuse in our audit selection and site selection. but we sure could do is spend time i'm not placed tax payers. >> was way to ask a question about the countries do it for's leg and we do and i think he said with a top-five and clients, but if there is mixing old of a country that figured out how to do this is great proficiency in terms of collecting taxes owed, i would appreciate you sharing it. the second part i think you've alluded to, as we started off with the premise, i receive it to be two and 44 from the irs

can sit down and to really fill it out, sign it in the mail back at some human being receives the paper and goes through it to see if i'm telling the truth or if it looks presentable. the whole system is starting to change and become paperless and information is flowing back and forth without the traditional peeper for them. so where would the king -- looking to a transformation in information gathering is the just described with credit cards that may make compliance easier, where he may not be burdening local businesses so much with filing forms, but rather having some basic flow through information that tells us what we need to know if to assert tax liability? >> so i think there are a couple possibilities. i laid out a long-term vision. we've got to get some of our quartet elegy done of actually trying to get btus, 1090 nines loaded into our system before

filing. so right now, the way out the reporting happened if those don't get it until after people file. so they can't use those as screens and blacks and visits back to the refundable credit question. and we got a concept of basically said we can figure out a way to frontload the issue, actually potentially work with private sector can make information available to people. rapid people scrambling and looking to file for envelopes of the important tax return information and open it up or keep a phyletic, we have a database that would have that. when people filed if there was a mismatch, but have to correct it before it came in. it would come into us. we got a lot better compliance on the front and in creed a lot less hassle for taxpayers because taxpayers are now defiling get it wrong, six months later you get a letter from s. beauty then have to scramble future records, pay

them again ago 32nd loop, which is probably unnecessary. i think that's one thing we can potentially do. second is i actually started an office reporting directly to me and compliance data analytics, which is looking at databases can try to make sure we are really smart about information we have and we are applying appropriate treatment screens. so for instance, we are looking at things like rather than sending out the standard for letters to taxpayers, which they get overtime, making a call to a taxpayer immediately when they have a tax liability to sort things out much like the credit card company and continually looking at data analytics to get better. on the flow through, it is more of a conceptual conversation, when we have took a full vetting with congress. as the 1090 nines issue showed, people are very sensitive about burden, but also the voluntary nature of our tax system in the government not knowing too much

about people. in her complaint shall be javaone be want as much information as we can. i think the world is what are information available that can move around a lot quicker and could be less burdensome ways to get information. >> one last question is do you have the information to elegy capability and staff capability to develop what you just discussed? a new generation about collecting and processing information that doesn't rely on the transfer paper? >> we've had this conversation. i think we have the staff capability. by i.t. leadership team that we have recruited that would put up against anyone else in the private air. we brought in a cto would then have to elegy for boeing, visa international has built an incredibly strong team and

that's why we are able under tough budget circumstances to finish this twenty-year modernization of our account database. with that said, where i came from, building big tech elegy in benchmarks and financial services you spend somewhere between 10% and 20% on capital investment because you're all about processing money, getting information, serving people, which is a similar model to worse. our capital investment, this president has asked almost doubled from 1.5% of their budget to just under 3%. so my object in view is that the agency for 20 years has been underfunded and kind of interesting technology in the future. we are just getting there and recognize constraints were under. i'm not going to make a request for a 10% increase or 10% of our

technology budget the technology investment, but i do think the future of running the nation's tax system is all about investment elegy, investment information that we need to keep investing. >> thank you. >> mr. chairman, thank you and aired the fire is 1090 nines issue to chairman durbin just talk about, as i understand your budget request included 23.382 million full-time employees attributed to the health care loss provisions. in light of this repeal, the irs request is reduced by 23.3 million a change -- i'm sorry, 82 full-time employees? >> yes, that's dropped. >> good. >> which escapes the money. >> what chairman durbin was

talking about caused me to want to inquire about the security. he mentioned the voluntary nature concern by americans about information -- the federal government having information about them. how secure of a system do we have in place that protects taxpayer information from those who would want to be there harm the system or steal information for their abuse? >> is very secure knockdowns. i tell everybody i was sworn in, came back to the office and the first briefing i had as irs commissioner was about protection of taxpayer data and data security. it's really built in the dna of the irs. there are laws that give it our individual employees from sharing information that any individual taxpayer with anyone and we prosecute aggressively when anything happens.

from the pure data security infrastructure, we've got extensive perimeter infrastructure around the web and we are continually monitoring that. we coordinate with all the federal national security agencies to make sure infrastructure is good. internal security we have blogs, monitoring, back down to one of the things i committed when i came it is any type what you put online lap 100% locked down data security. you have to make choices, but were never going to make a choice and data security. we take this very seriously and will stay focused on it. >> one of the reasons -- all shift topics, but one reason you would request for money and personnel is passage of the affordable care act. its constitutionality is being

tested in a simpleton like what we decided about the united states from court. in light of whatever the answer to deas, the magnitude, is the irs operating as if it is kind to shill going to be fully implemented? is very middle-of-the-road approach? i assume you're not sitting there waiting for constitutionality to be determined. are you behaving differently in the expenditure of money coming use of personnel, focusing resources because of the constitutional challenge? ..

we had started with a small amount of problem. we move toward what the laws on the books. >> timeframe wise for implementation of dca, what happens incrementally between now and 2014 towards full implementation? >> we go through series of additional use of resources, personnel and tax collections and enforcement. >> yeah, so you can really break up the work that we are going to need to do on the affordable care act into the technology infrastructure largely rounded refundable credits and connecting with the state exchanges and that is our biggest list between now and 2014. technology and operations is 82%

of the request and the 2012 budget. it is building the infrastructure to hook up with all the state exchanges so that when people are registering, they can find out their eligibility for tax credit, can find out for tax credit and then we have the information flows in the money flows with the insurance companies to be paying those on a regular basis. and then there are some very -- tax law in the affordable care act that we need to implement immediately. there is a lot of immediately effective provisions such as there is a tax on an excise tax on tanning salons, which was implemented and right now we are doing outreach to them. there are 25,000 was never had an excise tax so we are doing outreach education and then we will have a compliance program. there's a credit for small businesses to help them fight insurance or i mean help them buy insurance for their employees. there is a tax on branded

pharmaceuticals which right now we have sent out the initial bill to the branded pharmaceutical companies for that. they are verifying the data based on government purchases so there is that kind of work. that is a small amount of work so between now and 2014 there will be immediately implemented tax provisions in the work that has to happen there. but the big list is building the tech allergy infrastructure to be ready to interface with the state exchanges and the insurance companies around the $40 billion of refundable credits. >> and that was required in 2014? >> yeah. the open enrollment will happen sometime in 2013 and if you scope a systems built you basically need to lock down requirement. then do your bill and then do your testing so there is a huge list in 2012 around requirements and bills because by 2013 you

should be testing the system's. >> mr. chairman i think perhaps my last question is related to the national taxpayer advocate's testimony. she raised a couple of issues for me, talking about really customer service, taxpayer service. for irs fy210 management discussion and analysis including gao's auditing the irs collection relate to enforcement activities totaled 56.7 billion a 34% increase over 2004. by contrast out of the iris answered 74% of all calls from taxpayers seeking to speak with the telephone assistant in 10 as compared to 87% in 04. so a decline of 13%, 13 percentage points or 13% so less access to the live person on the

phone is the point that is being made here and then also this sentence that the backlog of taxpayer correspondence and the tax adjustment amatory is has jumped by 26%, representive uncontrolled correspondence, not exactly sure what uncontrolled means that not yet entered into the computer system has increased by 134% and a percentage the percentage of taxpayer correspondence classified as overreaching has increased by 135%. what are we being told and what does that mean? >> sure. as i mentioned at the beginning, i take very seriously the vast majority of americans are wrestling with a very complex tax code. their interaction with us every year spyware attorney get a refund and that is the last figure of us. i think about it and talk about it internally as we are big financial service operation and we need to answer the phones.

process paper and do all the things you need to do to serve the american people. the reality is we are right now operating with about 1200 less people than we were at the end of last fiscal year because we are under cr and our budget is slightly reduced. we have allocations to taxpayer service and we have allocations to enforcement of those enforcement allocations have a ring around them because they have a direct revenue producing effect. the reality in my mind is our taxpayer service operations also bring in revenue when we answer a tax law questions to help them get it right. e-file in those computer system so we can do managing, all of those accounts actually help get the $2.3 trillion in revenue. and we are trying to get a mix. the phonecalls i think we are

actually doing okay. we actually need more people to answer more phonecalls and we didn't get the request last year for 2011 and we put the credit -- request in for 2012 which will bring up that level of service. i would point out because we use this thing called the level of service. that is not in the taxpayer satisfied with the service. we actually have a 96% customer satisfaction rating on our phonecalls. we have introduced a few things which have dropped our level of service to increase satisfaction like wait time. so if the taxpayer calls and hangs up, that counts as a negative so that is not in the 74%. but we tell them is a 12 minute wait, you might want to call back at a less busy time. our paper inventory has been growing. we do put people on the phone to put people in the paper. the way we try to balance it is during march and april we be

sure to answer all the focus we can sell the paper gets backed up back definitely catch up with paper as we go. this request ask more customer service folks. we need people to process and open it up and look at it and make decisions about where it goes and things fall into error. so that has gone down. i have always leaned in and set around priorities. we want to make sure, technology is the key and we need to make sure we invest in technology. phones and paper and the web we can move people off the paper and the phone if we do more transactions on the web. it has to be invested in an frankly though, the conversation that ends up happening with people who spend time with the budget is there is always a tendency to put money into enforcement. we really need -- as you are pointing out in the taxpayer advocates are pointing out we need to keep an eye on a balance program. i think the president's budget is very balanced and will boost those numbers and so we will be serving people better but make

them -- in tough budget times they were going to be longer wait times and we will answer less phonecalls and papers will take longer. >> are there more inquires overtime with taxpayers calling for help? >> despite based on different provisions. we had a huge spike in 2008 when we sent out the stimulus checks to every american. where's my stimulus check? am i going to get one? vendor phonecall volume spiked in our level of service plummeted. we have had steady but a lot of it depends on tax law and what is going to happen. if you look at our affordable care act request, back to what you were talking about, technology and service to make sure people understand how the rules work and what they are eligible for is often the request. >> thank you commissioner, thank you mr. chairman. >> mr. chairman done of us have been accused of being in a tanning booth so i think you can go forward with your outreach without us being affected. i want to ask about the taxpayer

advocate. it takes american about 6 billion man-hours a year to comply with federal taxes. which, when you divide it out by the full-time equivalent employee is 3 million jobs just complying with federal law. when we look at how people then comply with this law in a practical way, about 60% of the individuals are hiring someone else. about 29% of people are interacting with software. it is a hidden tax on americans on average of about 250 bucks a year. it is really an extra tax on top of the tax that you pay to comply with federal law. have you thought about a way and it seems to be unreasonable to take 3 million americans in a country of 300 million to comply

with federal law. have you thought about a way to develop that matrix through software, get it down to 1 million americans? maybe just 2 billion hours to comply with taxes instead of 6 billion backs this is an incredible drag on the economy. >> so, as you know, the congress has the prerogative of passing the tax laws. our job is to administer whatever laws congress passes and the president signs. >> let me interrupt you on that. there are two ways in the 21st century we can handle complexity. the ideal way for me is a flatter, fair tax like what the gang of six may come up with to lower the rate to 26% but we will see. the other ways entirely in your hands, that an american doesn't pay h&r block. simply log onto the irs web site and fills out their taxes in an accurate, complete way in which the software is handling all of the complexity and the amount of

time spent complying with federal law drops like a rock which is entirely within your purview. >> so we were talking earlier about my few and looking at the metrics that we have under invested in the irs to knowledge he. over 20 years, not in recent history, so i will tell you frankly we don't have -- we need to build some things like art account database and get that off of a 30 year platform which your finishing this year. way to build some core infrastructure. we do have available you know, forms that calculate that people can go in and file on line directly with us. i think there is a big discussion about irs having software and frankly i think it is an administrative discussion but it is also a political discussion. speier total budget is how much? >> our total budget is about

12 billion. >> mr. chairman i think americans would love not to pay turbotax and not pay someone else. just my guess and correct me if i'm wrong, to develop a software package might ea 20 to 30 million-dollar job and then put it up on the web for free to americans. >> i guess i would say we have taken some looks at this. i don't think it is quite that simple and i think there are traces. >> actually i would disagree. it might actually be more simple because the software companies have to make software calls based on checking with you where is you actually all the rules and could be setting up the decision matrix because you are the authority. >> look him i would love senator to talk about this further and having talked about it here, i've gotten lots of letters on both sides of these issues about should we be in the business of actually the sets of choice is embedded in software or shouldn't we? what i would tell you is we have got a very full plate now off

technology of technology that we need to get done that would build a basic and restructure and start talking about those things. i would welcome a full range discussion about a. >> chairman of the something we can work together on because you shouldn't be a theological discussion. your mission should be to make it as easy as possible to comply with federal law, so this argument inside your shop should and again in our. then you say how do we then deploy software in a 21st century context of the americans get on, put in their basic data files, doesn't pay anybody and sort of like the e-verify program. we are making it as easy as possible with anderson at -- internet solutions to comply with the law. thank you mr. chairman. >> a call from h&r block. [laughter] thank you very much, and i don't think -- i think it is a valid question.

>> i do too. i totally agree. >> if we can eliminate the middleman. the middleman will hate it but it may save taxpayers money. i am looking for ease of filing. to put another idea on the table which will never pass as law, i made matt mentioned to you 15 years ago my account and died in springfield and i said, i am a lawyer, i am a senator. my tax return is not that complicated. i will do it myself. every member of congress should be required to do their own personal income tax. i guarantee we would have tax simplification overnight because i struggled with it for hours thinking, why is this so hard? because i don't do it and i didn't have a computer program to work with. it is just using my wits and it didn't turn out to be that impressive. the point i'm getting to is that the complexity of the system i think you would agree needs to be continually reviewed so that we can make it within the grasp of ordinary americans to

understand how their taxes are being calculated. if there is a mystery associated with it, there's a sense of injustice that somebody -- i am paying it in he isn't, that sort of notion. and it is expensive is that to get some of these tax repairs to do some basic returns. i don't think senator kirk is off base on that. i want to follow through and see what we can do on that. senator moran do you have any more? mr. shulman, we will have written questions for you and baby colleagues will as well. >> thank you very much. [inaudible conversations]

the senate armed services committee is holding a confirmation hearing tomorrow morning for leon panetta to be the next defense secretary, replacing secretary gates. mr. panetta is the current cia director and served as white house chief of staff for president clinton. he also served in the u.s. house of representatives. we will have live coverage from capitol hill at 910:30 eastern on c-span. a little later opined c-span3, the head of the customs and border protection agency testifies about corruption issues and drug trafficking along the u.s. border.

live coverage from the senate homeland security subcommittee gets underway at 10:00 a.m. eastern. >> three decades after the first cases of aids were recorded, more than 60 million people have been infected worldwide. it was 30 years ago that the centers for disease control reported that five previously healthy men in california had come down with a rare lung disease. this eventually led to the discovery of hiv, the virus that causes aids. next, the health and human services department discusses the anniversary of the disease. >> good morning everyone. thank you so much for joining us here today. i am richard sorian the assistant secretary for foreign affairs. is a joy and pleasure to welcome you here today. where the very full program so i'm going to simply judd has had distinguished assistant secretary for health, dr. howard

koh who will begin the program. thank you very much. >> thank you so much mr. sorian and welcome everybody. is so great to see you here. i'm dr. howard koh the secretary for health and we are thrilled you are joining us for this very important commemoration of 30 years of leadership in the fight against hiv, aids. today we honor the lives of those we have lost, whose life journeys are literally stitched into these aids quilt that you see around us. today we honor the dedication and persistence of advocates here and around the nation who have ushered in a new era of action on behalf of the country. today we honor the continued commitment of medical and public health professionals. that is everyone here for advancing by to the work and hiv prevention, diagnosis and

treatment, not just tear the country but indeed around the world. most important of all perhaps today we reflect on stories over the past 30 years. because this epidemic has touched all of us. you don't have to be infected to be affected by hiv/aids. i remember so clearly 30 years ago this month, i was a medical chief resident at boston city hospital, a young physician trying to help patients and i remember so clearly studying that first wave of scientific reports on hiv, trying to comprehend what seemed to be an and comprehensible condition. i will never forget the bitter stigma that surrounded the patients who were struggling to care for. i will never forget the courage of people across this country who stepped forward and try to make a difference in the face of this new threat. since then, we all know how this

virus has literally exposed the fault lines of our society. now, 30 years later, ironically we have a new generation that has arisen that has little to no knowledge of those early dark days. so today we share stories, not only of past fear and confusion, but also tremendous carrying, passion, compassion and leadership. today he will hear the perspectives and the stories of the secretary and many other leaders in this round. you will hear tremendous stories of scientific advances and progress, and we want to celebrate with you your commitment and the unveiling of a new generation of leaders who care deeply about these issues and share with you passion and compassion, understanding that the word passion means to suffer and the word compassion means to

suffer with. it is so critical that we share the stories today to build our community. there is a wonderful saying that a sorrow shared is half the sorrow and a joy shared is twice the joy. so that is why we are holding this important meeting today and working closely with you as we try to put this epidemic in our past. of course we are delighted by the commitment of the administration led by the president. many of us were there at the white house last july when he unveiled the national hiv/aids strategy. is a great pleasure to work with white house leaders like jeff who is in the audience today. we want want to thank all of you for your hard work on implementing the strategy. i am very honored to be part of that effort and on behalf of the secretary want to particularly acknowledge the contributions of our office of hiv/aids and infectious disease policy.

the work of aids.gov led by gomez and the head of the implementation of that. is wrong here? candidates wave? stand up and get a round of applause, wrongron, will you? thank you. [applause] socom in and in closing we note that the history of hiv/aids began some 30 years ago, an era of illness here and death and we hope that with with this anniversary the market new chapter that is marked more by hope and promise for the future. we need each of you now to do more than ever before to deliver your healing touch, rich education, advance research, prevention and advocate for the vulnerable. we have made so much progress in this past 30 years. we look forward to the day that together with you, we can see

that this devastating disease as part of our past and not our future. thank you very, very much. [applause] i am actually delighted now to introduce a tremendous community leader, dazon dixon diallo, the founder and president of sisterlove inc.. this is a very prominent women's hiv/aids support organization based in the southeast. she is a wall and with tremendous passion and compassion and i want to thank dazon dixon diallo for joining us here. [applause] >> thank you so much dr. koh and thank you all for being here, and for being here. alternative needs con, debbie

thomas, janice giroux, martin delaney, novella dudley, willie brown, pandora singleton, arthur ashe, so many hundreds of thousands of others are also glad for you being and being here. in the summer of 1981, i was a 16-year-old rising senior at each county high school. in fort valley georgia. one of those places where it took a bit longer to get the word about the strange new deadly illness that we soon came to know as aids. now by 1985 i was a college sophomore in atlanta, but i was also ready and working and advocating for women's reproductive rights. and by the end of that same year, thanks to root hudson's famous disclosure -- that is another longer story -- i was

volunteering at our local aids service organization. since that time i founded and cofounded several organizations including sisterlove which will be 22 years old next month. i have planned and participated in demonstrations with everyone from act up to the treatment action campaign. i've worked with community planning for prevention and planning for treatment and care. i have buried more friends and colleagues than most of my college classmates will ever very before the become seniors. i have married and divorced a man who let me but not enough to hang with me in this fight. i have forgone spending summers in some holidays with families to sit with sick clients or write another grant or attend another meeting. i have met and worked with so many amazing, smart, dedicated and giving souls and i have a community.

that is you all, that identifies with me and my passion to end this disease and its terrible impact on individuals, families, communities and even nations. i have learned to keep looking forward and envisioning a future in which there is no hiv or aids and to keep working to bring that future into my present because that is what all those people for whom the end of this pandemic comes too late. i have learned that love really does conquer all. even when we don't know it, see it, or feel it. now, you know we have been in this for a very long time and i swear i saw it back in the mid- 80s -- thought that by this time in my life i would be on a beach writing somewhere where i call nonfiction. [laughter] i think that is still in my future. but we have still come a long

way. despite how far we have come with enough creating evidence-based strategies, with having lifesaving quality of life giving treatment and a network of social service providers and educators and supporters and peer leaders, finally having a national strategy, a plan that we can all get behind and work with regardless of some of the challenges we still put to that plan. we still have a long way to go. where i live and work in the south, no, the deep south which is way more than a two graphics thanks in, stigma still exists. i'm still waiting for my more than magic campaign. y'all got that one? discrimination is not yet been eradicated and people living with hiv and aids are still at risk of targeted criminalization, disclosure status is still a risky endeavor in terms of family, employment

and dignity and while our strategies might not be a perfect tool, it is the tool we have to work with. we are also having to keep the fight and defending the prioritization of hiv/aids. that is why i'm still here, because even though i know i am in the business to put itself out of business, i am not here to go out of business and given the fact that we have thousands of people on the list, half of whom are in georgia and florida, the news today at "usa today" tells us that we still are not catching people early enough to keep them alive longer. we still have a lot to do. which means you get cannot rest. you still must find your inspiration and your energy. you still must call the names and remember them and call on them as your own soul guide. we must continue to figure out ways to lift up the importance and the meaningful engagement of

people living with hiv. i am reminded that from the beginning of this, community has always been in the forefront. we have been in the front of science. we have been in the front of policy. we have been in the front of social, cultural attitudes and ideas. we have affected change in every sector. we have galvanized systems, but it seems to me that in the last couple of years, at least where i live and work, some you have to be careful what you asked for things where community has fallen a little bit behind the policy and the science. policies in front of us. that doesn't necessarily mean we are going to solve all of these problems just for science in just policy. i am here to remind you that, while science, research and policy might be the body of the

end of this epidemic, the community, civil society, civil service, people living with hiv, are its sole. body and soul, we work it. we work it together, we work it as one. so i'm going to be here until the end of this thing and i'm just going to continue to wake up every day, call on our collective ancestors of people who are no longer here as the result of hiv and aids into the good work that we need to do together. thank you. [applause] now, it is my absolute pleasure and distinct honor to introduce a woman who may not need an introduction but you are going to get one anyway.

in her two years as secretary of health and human services, secretary kathleen sebelius has been a champion for improving our health care system and fighting the hiv/aids epidemic are going fact, she has combined these fights to make clear that comprehensive health health carr all americans must include people living with hiv and aids. and, as a person who has fought for reproductive justice since the age of 17, i personally thank her for fighting to protect reproductive health and family planning services for youth and for women across this great nation. ladies and gentlemen, comrades, secretary sebelius. [applause] >> i want to start my thinking

dazon for not only that kind introduction but for her amazing work over years. she has tireless leadership in the fight against hiv/aids and every day through her work and threw her example gives hope and courage to some of the most vulnerable women and families around the world. so let's thank her again, please, for being with us today. [applause] and i also want to thank dr. koh, howard koh who as the assistant secretary of health, has tackled a number of issues and has taken leadership roles and a number of areas but i can tell you his experience and passion has inspired him to be particularly focused on our continued battle, our national strategic plan, our efforts on hiv and aids and thank you

howard for continuing that battle. you are going to hear from some remarkable health leaders who have been generous enough today to share their personal stories with us and i am struck by looking at this audience that we have an interesting combination of health expertise in his room. some of you have been here from day one and no but we are going to talk about. others were not alive when this story first began, so some of this is important history for you to understand and know about. but today, we are here to remember those we have lost to the pandemic, and to honor those who continue to fight against the virus and fight for a cure. we are here to mark the gains made over the last three decades and to look ahead with hope and purpose at the next steps we have to take in this fight in the battle.

battle. the story of the first 30 years has been one of great commitment, discovery and collaboration. but it is also a story of great uncertainty and terrible loss. more than 600,000 americans have died long before they should have, 600,000. these quilt squares represent just a few of those souls. worldwide more than 30 million people are living with hiv today, including 2.5 million children. it could be easy to focus on all the data, the dollars and the scientific milestones that we so often used to measure our progress and they are important, but we can't ever forget that the story of hiv/aids is one of countless individuals, human lives. so many of us in this room today never thought this disease would still be with us three decades later and as i said earlier,

there are some of you here who weren't alive when this epidemic began. just think about that. a generation of people who have never lived in a world without this virus being present. in this age of advanced treatment, when hiv is no longer a death sentence for many, it can be easy to forget how scary those early years were. when it was first discovered, no one knew how the disease was spread and we didn't know what caused the disease. what we did know is that almost certainly meant death. wine advocate compare these early years to living in a war zone. we were never sure when the next bomb would drop and with that uncertainty came a lot of fear. and with the fear came an enormous prejudice. children like ryan white were turned away from their schools because they were hiv positive. tenants were locked out of their apartments and forced to live on the streets.

workers were fired from the jobs they had held for decades. sons and daughters lying in hospital beds were abandoned by their families and their loved ones. and treatment was very hard to come by unless a qualified for medicaid or could keep a job that provided insurance. and the treatments that we had weren't very effective and certainly not as effective as anyone would have wished. our national government was frankly very slow to act, and so it was community organizations bringing up on street corners around the country, the souls that dazon just talked about, that many people's needs, the connected individuals to treatment. they educated them about how to protect themselves to battle discrimination and got this nation's attention. and they taught us most poignantly that silence equals death. now many of you know this story because he lived it. and he went on to build strong

coalitions that included government and community-based groups, employers, health professionals and individuals with aids coming together with a sense of urgency to develop better approaches for treating and reducing the spread of the disease. no single narrative can do justice to our journey over the last three decades. there are instead a million individual stories sewn together by a shared hope for progress. science must keep moving forward. prevention must reach even further and be even more effective. and all people living with hiv and aids must have better access to treatment and care they need whether they live in washington d.c. are in a village outside of nairobi. over time, in some instances a relatively short time, science took what was once and

impenetrable mystery and began to uncover answers. the kinds of answers that not only worked in the lab but also save lives. thanks to the work and ingenuity of scientists and doctors at places like the centers for disease control and prevention and national institute of health and the food drug administration and our own hrsa, new effective therapies and treatments and tools for prevention came on line. today, there are more than 30 licensed drugs that are widely available in the developed world and have begun to transform hiv into a chronic disease, adding years to people's lives. but we know that progress is not enough and it is wide president obama has made the fight against hiv at home and around the world a top priority for his administration, including the first-ever development of a national aids strategy that is providing direction and focus to our efforts.

the battle isn't over. as long as this virus threatens the health and lives of people here and around the globe, the struggle continues. and so on this day, in this place, we need to remember the words of "mother jones," who told us to pray for the dead and fight like hell for the living. and that is what we are going to do. thank you and now i would like to turn things back over to richard and you will hear from some of our terrific leaders. [applause] >> thank you madam secretary and thank you for joining us. the secretary is now going on an event to promote childcare and healthy childcare for children so she is fighting on every level. we appreciate your taking time. let a welcome you again to the great hall. we call this the great hall but

until today and never really thought of it is great. i wish we could keep these quilt panels forever because this is life. this is what this is all about, and so take a moment when you can't adjust look at the quilt panels and remember these people and all the people that were close to you. elliott russo is an author and survivor. he taught us that whoever survives the test, whatever it may be, must tell the story. that is why in part we are here today. when hiv started in 1981, i was 23 years old. i was in my first job and i was a journalist here in washington writing about health care policy. who knew? and i wrote some of the earlier news stories about a disease that didn't have a name or

didn't have a decent name for a period of time. i never thought that 30 years later i would still be working in some or part of my life on this epidemic, not just working but living through 30 years with so many people. and i am glad. i'm glad that i am, not because of the epidemic has lasted this long but because it is change my life the way i'm sure it is change the lives of everybody in this room, for the worse but worst but also for the better. so one of the things we need to do was remember and not forget of what the secretary or reminded us. there is a generation of people who left grown up in this world never knowing a day without hiv in our lives. and there will be generations to come. we need to make sure that today but also when the epidemic is

over they remember where they came from. we have got a short video before the rest of our speakers join us and i hope you'll find this to be both informative and enriching. i think they are going to queue that up. speech in fifth, 1981, the cdc published a morbidity and mortality weekly report describing cases of a rare pneumonia in otherwise healthy young men in los angeles. >> it was from those reports that the great epidemic of the 80's began to mush from and we were in the midst of it before we knew it. we didn't know what it was but i made a decision in the middle of the summer of 1981 that i was actually going to change the direction of my career and start bringing into the hospitals and study these unusual situations

of men who had the strange disease. when the pattern went from gay men to injecting drug users and the person with hemophilia, there could really only be identified viral agent that could be transmitted through a variety of means. once we got the virus in our hands, mainly in 1984 and 1985, then we began to study in ernest some of the pathogenic events. >> by the time the virus was discovered there were more than 500,000 people in the united states infected and millions worldwide. >> we saw, really ended up following in the aids clinic about 25,000 patients with hiv. the average person we would see would have four or five opportunistic infections and then succumb.

>> aids was and is a public health problem but one with many social and political facets. >> these communities response was a mixture of insider and outsider tactics of sitting down with policymakers and trying to work out and find the best solutions. at the same time a lot of street activism, a lot of demonstrations. >> the activists were making extremely good points about the uniqueness of this, the need to do more, they need to be less rigid in our regulatory approaches toward the approval and testing of new drugs and the rigidity and lack of flexibility in how we design clinical trials. >> 1985 was was the year a of boy with hemophilia named ryan white was barred from attending school because he was infected with hiv. that same year, actor rock hudson died of aids, bringing attention to the disease in a way no one had before.

in 1987, the aids memorial quilt was displayed for the first time on the national mall. the following year, his message, understanding aids was mailed to every household in america. in 1990, ryan white died at the age of 18 and congress passed the ryan white care act, providing access to treatment for uninsured people with hiv/aids. >> because of the hiv virus that i have attained, i will have to retire. >> the following year basketball star magic johnson held a press conference to change the way many people thought about hiv/aids. the early '90s were marked with progress despite some setbacks. in 1994, an nih child found avt was found to prevent transmission from mother to infant during childbirth, the first protease inhibitor was

approved in 1985, huge advance in managing hiv infection. however age remains the leading cause of death for african-americans. >> we are 25% infected in 1986 and yet, the response in black communities and the delivery of services at that time primarily, prevention and awareness, for black committees were disproportionately low. >> by 2000 to about half the people living with hiv worldwide are women. >> for women to recognize the risk, especially for header sector -- not heterosexual latinos in the west i think risk awareness is still a very very very big topic. >> has the academic entered its third decade the focus turned global. in 2003, president bush announced the president emergency program for aids relief for pepfar. providing billions of dollars to find and treat hiv/aids in countries around the world.

>> pep or has been the most remarkable program. we are now at 3.2 million people on antiretroviral treatment. all of them would have died. i think it is a remarkable contribution and the american people should feel very proud. now as part of present obama's broader probe -- opal health issue. is being linked to other opal health problems. >> today we are releasing our national hiv/aids. >> announced in 2010, present obama's national hiv/aids dreaded g. was aimed at preventing infection, expanding access to care and reducing disparities. >> i think we are in a period of time where we have the tools and across the globe. that is critically important and it is exciting. [applause]

>> you wow. 30 years and five minutes. i think i've got a few more gray hairs. several of the people who are kind enough to participate and give us their memories and their thoughts are here today and i want to thank them as well. the word hero is overused, so i will try not to use it too often. i will just say our next speaker is a hero of mine and a leader throughout this epidemic. let me introduce tony fauci. [applause] >> thank you very much richard. it really is an honor and a privilege to be here this morning to commemorate this extraordinary time in our history. 30 years of hiv/aids.

looking around the room i don't know whether it is true or not, but i may be the only person here who has spent his entire professional career at the department of health and human services. [laughter] for a very long time. so it is really good to be here with you in this building. i just want to take a couple of minutes to share with you the kinds of reflections that those of us who were there from the very first day had when we saw the unfolding of this historic and extraordinarily tragic evene evolution of the beginning of this hiv/aids pandemic. as i often say when i talk to people about subjects like this and similar subjects, it is really quite true that when you are living through or beginning to live through historic event, you don't really appreciate that

it is historic and tell you actually reflect back on it. it is sort of a quirk about history. you don't say wow i woke up today and this happened, is going to be a stored. it really has been a historic event that is brought out in many respects the best and the worst in people throughout the world but having been through it from the beginning, i can say now that the ultimate experience is one that has brought out some of the finest qualities of mankind. you saw in that clip their, i remember very clearly -- there are things in your life you remember and you know exactly where you you were. is sitting in my office at the national institutes of health in bethesda doing my job of working on basic and clinical research when this mmwr that you saw on the screen, landed on my desk. june 5, 1981. i remember reading it.

what a curiosity. five men from los angeles curiously all gay, otherwise well with a disease that i knew very well was an infectious disease and only seen in people with suppressed immune systems. i thought it was a curiosity that would go away and then one month later on the fourth of fourth of july of 1981, a similar mmwr planted on my desk, now reporting 26 men, again curiously all gay men, now from l.a., san francisco and new york city. not only with pneumonia but sarcoma. i remember for the first time in my medical career i got goosebumps because i knew that this was something new and something horrible, but i never in my wildest dreams would have imagined what would unfold for us in this country and throughout the world. i'm very proud to have been in

this organization, and the department of health and human services and at the nih during those eerily years when we were struggling from both a scientific and public health template about how we were going to address this pandemic. i referred to it as the dark years of my professional career, because unless you have done that it is difficult to describe what it is like to have people come in who are suffering and dying and you don't have an idea or a clue about what is going on with them. you suspect infection. epidemiology tells you is sexually-transmitted. also later on injection drug use, but yet you don't know what to do with the patients except palliative care. and it was over the period of those three decades with support from so many groups here in the department, through the department at nih, through

multiple of administrations and multiple turnovers of congress that we had the resources to put into effect a scientific research, both basic and clinical, attack on this pandemic to the point where we now, 30 years into it, have the capability of really putting an end to the aids epidemic. there are certainly scientific gaps. we still don't have a vaccine. their implementation gaps. we still have not been able to get penetration into communities, voluntary testing, linking the care and treatment of individuals which we know now treatment can service prevention. so there are really many, many challenges ahead. it is both humbling, but also energizing, to realize that we have, a very, very, very long way but in the same breath, as we realize that in the same

thoughts that we assimilate that, it is clear that we have a very long way to go. so although we are now three decades into -- entering our fourth decade into this pandemic, i would hope that a day like today where we come together and remember the experiences we have, that way we confirm and we commit ourselves to the important tasks ahead because as i have said very often, we as a global society are going to be judged as much as the advances that were made over the previous 30 years. we are going to be judged even more by what we do in the coming years because we now have the opportunity from both a domestic and a global standpoint to put an end to this pandemic, and i can tell you all in this room that i will to everything i can to stay in this fight as long as i can.

hopefully one of these days i'm going to come down to this great auditorium and talk to you about not the challenges of the future but a commemoration of something in the past that is now over. thank you. [applause] >> thank you tony. one of the things that dr. fauci's remarks reminded me of, has become fashionable again lately to use public employees as punching bags to talk about bureaucrats and about government people needing to work harder and all that. we have to remember that many, not all that but many of the scientists in the public health professionals and the caregivers and others that were working on this epidemic from the beginning worked work here at this department, worked in other parts of government, worked in state government so there are a

lot of public service heroes that continue to do that work every day. we need to remember that they are scientists, there are physicians, there are public health physicians that they are also our colleagues. i first met daniel mentally a -- montoya and they worked at the white house office of national aids policy. did some traveling around the country to visit programs and really find out what was going on on the ground. of course daniel knows better than most anyone i know and he has been an advocate and an outspoken leader on this epidemic for a number of years. he now serves as the deputy executive director at the national minority aids council, one of our leading advocacy organizations. daniel will share his thoughts. thank you, danielle. [applause]

>> thank you richard and good morning to everyone. i would strictly like to also thank the department of health and human services for hosting today symposium. is really important to take a moment to reflect and 30 years is that moment to reflect. this administration has demonstrated a laudable commitment to fighting this epidemic and will be a critical ally into the fourth decade of the struggle. i would also like to thank my distinguished panelists, some of whom i worked with and for. i'm extremely honored to be in the presence of such amazing advocates, allies and trailblazers. many of you are in the audience. as richard said currently i service deputy executive director banesto minority aids council and i started that opportunity this past year in january. i would like to recognize the staff of the national minority counsel, especially executive director paul, who allowed me the opportunity to come back into this world to be able to

advocate more directly. the national aids council represents a coalition of 3000 community-based organizations as well as organizations advocating a delivering hiv/aids services to communities of color -- my. since 1987 and n has developed leadership for a variety of africa see campaigns, public policy education programs, national conferences, research programs, capacity building technical assistance and treatment and training and digital and electronic resource materials. like so many gay men of my generation i got involved in aids advocacy because of the epidemic impact on me directly. i was diagnosed with hiv 24 years ago. and i make a point to say diagnosed instead of living with this for years after aids was first discovered there was no test for the virus. i finally got the courage to test ford in 1987 but had no

idea i'd and positive before that because up until that point we had already been practicing safe sex and using, which was really headed a lot by the community. luckily, i responded well to treatment and have lived a relatively healthy life. however, many of my friends, family members and loved ones were not so lucky. after being diagnosed i reevaluate my priorities, bandaging the job that i had really looked poor and longed for in terms of working on wall street to come back to texas and work for change. while i haven't looked back, i do look back in terms of remembering why it is that i continued to fight this fight for all those people that i sat at their bedside who were dying and for the promises that i made to them to continue this fight. ..

has not budged from about a decade holding steady at 56,000. our nation's prevention efforts seem to have hit a wall. while there are many reasons for this including adequate funding, lack of evidence and age appropriate sex education programs and general complacency is an issue that we need attention on. the continued disproportionate impact on the minority community itself also poses additional prevention challenges.

in the african-american community where infection rates are seven times as high as caucasians the prevalence of the virus makes each encounter riskier. this is by identifying the evidence based are so critical. 30 years into the epidemic it is naive to assume everyone will use one condom hundred% of the time to read what the reasons for an entel to use condoms which could be like of intimacy, fatigue or the occasional pour decision it's critical that we extend the approach to prevention without judgment. if sexual men and women have unprotected sex wants his or her chance of contracting the virus is significantly lower than to gay black men who have a single unprotected sexual encounter. in the programs they pos sycophant challenges. recent studies pointed to the incredible efficacy of treatment as prevention of for possibly

the best hope for practical approach to expanding prevention efforts. a study released just last month reviewed early in the sustained treatment with the antiretroviral medication's reintroduce the risk of transmitting the virus to your partner by as much as 96%. for the minority communities facing significantly higher unloads and prevalence this is a hugely promising development. assuming that we can get everyone diagnosed with age of hiv this could reduce the risk of transmission with each sexual encounter, even in groups with like a gay black men. the critical point in the last statement is whether we can assure all people living with hiv can get on drug therapy. currently more than 200,000 people living with hiv in the united states are not aware of their status. any effort to enroll those with hiv and and try antiretroviral

therapy would require a renewed push around testing. it would also require athan is to insure people can access care once they are diagnosed. current programs are simply inadequate. and medicaid for example requires that a person be disabled by access treatment to the program and most recently we were satisfied to see they would be released to states on the 1115 wafers we think would be helpful in terms of building the bridge to the affordable care act for 2014 when medicaid will become that opportunity. ryan white faced shortcomings in funding particularly in the age drug assistance program. these programs provide medications for the loans to individuals not eligible for other programs like medicaid and like said earlier, there are states in the south that are incredibly impacted in the states in the south are really communities of colors that are being impacted. currently 13 states have

instituted while the program have introduced a variety of so-called cost containment measures like enrollment and reduced formularies. there is great hope and that was referenced in the video that you saw earlier in some of the fact that we've been participating early on and that comes about through the importance of health care reform in this strategy. the passage of health care reform and the national strategy will go far in addressing these challenges. health care reform will improve access to care by preventing insurance companies from dropping the enrollees when they are diagnosed with hiv. will also keep private insurance companies from denying coverage based on the diagnosis on capping spending on treatment. health care reform will also expand medicaid eligibility committee eliminating the requirement that a person be disabled by aids prior to being eligible for the program. the national strategy and to

decrease in infections and expand access to care and minimize health disparities. one of the ways that aims to achieve these goals is by focusing resources on those communities where the impact of the epidemic is more severe, mainly minority communities. in other words, the call for funding to follow the epidemic. this will go far in addressing the prevention shall just posed by the disproportionate impact of the epidemic while at the same time must be careful we do not abandon one's community health for another. for example while the asia-pacific community have the lowest infection rate of any racial ethnic group in america, it is also the only group with infections that are actually on the rise. if we based our real vacation to it co -- relocation we could worsen the epidemic and others. while programs like threats in

the use of treatment is professionals active again promise we must ensure continued funding of traditional prevention programs in the prevention arsenal are only effective in concert with the practice and regular condom use. in today's climate efforts to reduce the deficit of occasionally put prevention funding in jeopardy to the credit of this administration and has continued to push for sustained prevention funding both to cut funding including for planned parenthood could have a devastating effect on the nation's fight against this epidemic. instead of cutting the programs, it is critical to note each infection that is prevented saves over 350,000 in lifetime medical costs much of which falls on the tax payer. preventing all 56,000 annual inspections for just one year could save as much as 20 billion in lifetime medical costs.

if you multiply that over the period of a decade, and looking at potentially savings in the hundreds of billions of dollars prevention is an investment and something we must really looked words. it is not just an investment in the citizens of this country, it is in our economic security. finally, i think the most important thing i can save someone that's been living with hiv in the treatment that has happened over the 24 years is that i am able to be standing here and doing this work and advocating for the needs of people living with hiv/aids. but there's also the benefit that i know of that is important to me that i've been able to bridge is paid in, and that is being able to be around to see my parents get old and take care of them in their twilight years as they've been taking care of me when i was dealing with -- when i turned 23 and they were there as my support. and so that and the science and

for all the work that's been going on, that's been the greatest gift for people with hiv/aids that we can be there for others to do the work including our own families to take care of them in their own twilight years. thank you very much. [applause] >> thank you, daniel, so much. it's easy for us to focus in on the domestic of epidemic. it is devastating and continued as we talked about but one of the most important things we've done in this country is look outward at the pandemic, and as the video talked about little bit, that president bush launched is one of the most amazing public health initiatives particularly global health initiatives and our time. mark was the president's side as the global aids coordinator

getting that program going and we owe him a debt of gratitude and now he's a scholar georgetown university, inaugural fellow at the george bush institute and he's joining us today to talk about the global pandemic. thank you. [applause] >> good morning. i would like to begin by thanking tataris sebelius for posting as. putting a spotlight on hiv/aids which is so important as many things are going around and many other important issues on everyone's plate it's good to be back here in public health services for 14 years so it's good to be home. leadership starts with you devotee and service and no one knows that more important in the global aids epidemic and how the american people are responding globally. the opportunity to assert is often a series of accidents and in my life the first in the mid

80's reading the cover story on "newsweek" about global hiv/aids and like tony there was something inside me that told me i should leave the academic career i was pursuing in the humanities and pursue hiv/aids. the second accident was tony. i was fortunate that he picked me up and shepherded the and mentored me in his laboratory and as president bush turned to him and a small team to develop pepfar he was kind enough to include me in that process and then president bush launched the largest international initiative for a single disease and the was hiv/aids was also with randy and the first global aids coordinator and fortunate enough in another accident to be there as he moved on and to be named coordinator. president bush's leadership was needed and it's difficult remember looking at how far we've come that two years before it was launched, we had almost

no global leadership and in fact, treatment for hiv positive patients and hiv-positive people on the global effort was blocked at the united nations as a millennium demint goal. and was blocked as a millennium development goal on very pernicious arguments. arguments that africans were uneducated and poor and therefore could not do something as complicated as treatment despite having the science. the slander was compounded by something that was being promulgated that africans were so promiscuous there was nothing that could be done to turn the epidemic around. we know from science the if you were sexual partners than americans do over the course of a lifetime. and in the context of that general, we can't do this with africans can't do this, president bush and the american people stepped up and said yes they can we believe in that in

the last at administration, too. [laughter] >> i knew the truth and tony knew the truth that that was a slander because we were doing the work in africa with heroes like peter and alex who were actually delivering antiretroviral therapy already and we knew that what they needed was support and that comes back to leadership being about humility and service and understanding that africans actually can not only solve their problems but are among the dedicated and innovative people and if you support them and give them a chance, they will solve their problems, and that's precisely what they did with pepfar. pepfar was not about americans doing, it was about americans supporting africans from the village level to the state houses to solve their hiv problem and that's why tens of millions of people had their lives with the up and saved. president obama is continuing this theme and carrying the

torch. his speech was on a point and fully part of the bush viewpoint and so the continuity to say that africans must lead and will lead and americans will support and president obama's global health initiative is a natural evolution of what was begun in the bush administration and in fact so much so the bush institute focused on similar efforts working with the obama administration and his extraordinary team of people in the development and global health care it being one of them, many of you in the room being one of them from across the government at the white house, state department, u.s. aid come here at hhs, the peace corps and department of defense bigot pepfar keen had a unique moment in history where the science gave us the opportunity to support people for prevention, treatment and care in combination which is what pepfar was all about. people focused on the treatment but that wasn't the only issue. this audience was there and as president bush said at that time if we have the science it was a

moral the imperative to not let people die. we are now at a similar crossroads on prevention. while we could do some combination we had behavior change including condoms where we could have a combination approach as we were ending the term in office male circumcision can on reducing infection by 50 to 60%. we now have treatment as prevention as daniel and tony pointed out we hope for pre-exposure we can do it for men who have sex with men and hope will be more effective for others including young women hopefully in africa. we have a microbes real possibility coming onstage. we now have the science that will allow us to drive this epidemic into the ground. and just as we have the science with treatment and we could have done as many people said here financially we can't do it. we said this is why we can do it. we have the opportunity to

homages here are the problems of implementation, we have the opportunity to grasp this moment in history again and say this is why we can do it and this is how we will do it and how we will do what is by supporting africans who if we support them will solve this problem. they will figure out how to. will we need to do is support them. so as pepfar dressed in a ministry we are hopeful that we will grasp that moment in history to drive this epidemic into the ground through prevention, care and treatment for an hiv free generation and all of those on this stage who have been privileged to serve and to have the opportunity and humility to serve look forward to supporting all of you and future generation of leaders as you tackle this problem as you own this problem supporting africans to solve their problems. [applause]

>> thank you. i had the pleasure to work with helene d. in the mid 90's at the center for disease control and prevention and i got to see leadership at work really advancing prevention and advancing a frontal assault on instructions in this country. she is now president and ceo of care usa and serves as the chair of the president's advisory council on hiv/aids. [applause] >> thank you so much, richard. as always, when you're the last speaker many people have already made some of your points, going to be relatively brief so we can start the panel but i would also like to thank secretaries sebelius and assistant secretary coal for having us here and for

the leadership could they continue to show not only for hiv but for hall for around the country, and i had the opportunity to work with both of them and in my role with the president's aids advisory council and appreciate what we get for them, christopher bates who is there and i really want to thank jeff crowley who was my partner in crime who heads the white house aide's office and a lot of people like to call out but just to say how thankful and privilege i am to be back here again as many people on the stage set i spent 20 years as a commission officer at the center for disease control and a few other assignments so this building is home for me and it's great to be coming home like this. i also will say i have to mark

this data the first time i ever heard tony thought she be called an accident. [laughter] >> i will remember that. a good accent. so richard asked me to say a little about might have and more from a personal perspective, so i will do that. when hiv was first discovered other than to read about it as a medical professional. i then went on to the centers for disease control because i wanted to have some experience

in public health and thought i was going to spend 20 years, but when i first went, and you had this the opportunity to choose your different assignments i thought about hiv because i felt this was an interesting fascinating how new issue, and almost everybody told me to stay away from it because they said this is a kind of strange political views and by a we it's not going to be very serious and in a couple of years we will have figured out why don't you go spend your time on something that's a real public health challenge? obviously i didn't take that advice and the first couple of years i did something else but i soon got drawn to work on hiv and aids, and by that time we were beginning to realize this was going to be the deciding public health issue of our time

but in many ways the defining human and humanitarian issue as i think several of the speakers mentioned, and for me also say i didn't choose hiv, hiv and shows me because i was fascinating scientifically but it also had social the imperatives that called to me and i've always been a person very involved, was an activist wanting to work on social change issues so hiv, which doesn't on the one hand does not discriminate and don lever and isn't randomly distributed and we know that in many ways hiv does show the fault line in a society where it is in this country and the disproportionate impact it has on people of color, people who

inject drugs, the men or whether it's art of the world where it is the biggest impact on those living in extreme poverty and particularly on women who don't have the devotee within the context of their lives and relationships. so, we know that -- for me hiv was a calling in many ways of many people here have said and i will just end by saying for me as others have said, i marked my life by many of the chapters in this epidemic whether it was when we first started talking about the disproportionate impact on communities of color, heterosexual, transmissions, the global epidemic and also mark my life by the aids conferences, and every year there's a

different flavor and the environment in the conference that oftentimes has to do with whether the discovery are limited or hopeful like the vancouver conference in 1996 where combination therapy was first ruled out, so i think we have all come to mark our lives, and luckily we are marking our lives less by the number of people who are dollying in our life who we love and more by the advances people have already talked about, and that is what is hopeful about this epidemic and i think the other parts that i always find hopeful is that there are people like the people on the stage and the audience and others who are part of a caring community and i think all of us can see that as a result of working on hiv, our lives are richer than they would have been before were more human in many ways than we ever were before. we are more equal and think about society in a more equal way than we might have before,

and so while this has been a horrendous epidemic and affected people in and around the globe and in harmon displays, i think it's also helped to form a more human approach to life, to health and medicine in ways we will never turn back from so those are just my comments and i look forward to the panel. [applause] >> thank you. before we start the discussion coming and we also have a microphone up front and i'm going to ask people to come forward and ask their own questions. i just want to thank all the people, and i can't name them because i will remember all the names of who worked hard to put this together spending months of hard work and most of them are in the back not taking up seats because that's the way they are much effect colleagues and please join me in thanking them

for the work they've done. [applause] ceramica this is my oprah moment. [laughter] >> i'm going to ask a couple questions to to get the conversation started but if you can come up if you have a question or comment, please feel free to do so. i'm going to ask two questions. one first is what makes you the most optimistic about the epidemic as it stands today? what gives you the most hope? >> several things. one of them is that over the last couple of years it is clear that we have already within our grasp the scientifically proven capabilities of getting our arms around this pandemic in the sense of turning around the dynamics of the epidemic so that instead of seeing this, we are

going to be starting to see this and it has to do with what i mentioned, that the mark and others mention is the issue of compensation prevention modalities. there has been in the past understandable but not appropriate tension between treatment and prevention and we know now what treatment is prevention and in addition to the things we know work, circumcision works even better than we thought that it did in the beginning we know that on a certain set of circumstances pre-exposure prophylactics work. we know that interventions such as topical microbicides even with modest adherence work and with greater adherence would work even better. if you put all those things together right now, we need to implement things in the way we get the best bank for the buck dhaka. before there were so many scientific gaps that even if we

were able to implement them, we wouldn't have the tools to do that. our tool kit is getting more fully and fall and it is up to us to implement that now both domestically and internationally so i feel good about that. >> do any of the other panelists want to add on that? >> i would agree on that. i guess i would flip it around a little bit. what am i most pessimistic about because i totally agree that i think we have now more than ever an opportunity with all of the tools we have for prevention and treatment, but i think we also have the potential for taking our off the ball and not continuing to keep the resources that are necessary to go to that next sooner or later last mile,

so i think it is easy to get too optimistic and take the heat off because there are lots of other issues. we have a huge economic crisis on our hands. there's a lot going on but we just cannot for the 30 years we poured into this and the people's lives who have been lost, we cannot let this opportunity to put these tools to use and make sure they get used by those who need it the most, and that's going to take a lot of political will. >> i would add two things that make me optimistic. but the number of people from the villages, and this is true whether it is the united states or africa, the people on the ground in the communities and the health clinics and hospitals that is they are there to do the work. the creativity and the

innovation, and if we just supports them they will actually figure it out. they have the last five years never come seven years and in the united states the last 30. if we support them they will figure out. the second thing is the history of bipartisanship and in a city where we have a lot of partisan concerns, hiv/aids, global and domestic has traditionally been areas of common ground although they are difficult policy issues we've worked through them so we have an opportunity for using that by partisanship and some of that grows from the fact and financially difficult times there are few programs where you can show a direct line from a dollar invested with their that is in the united states or africa and as we move into health in general that is true, not just in the hiv/aids and certainly globally with the global health initiative and integration which we did so in

the bush administration and the natural evolution is carrying on. we can make the argument in a way and there is this sense in the united states that we are even in our most difficult financial times part of the global community and we care about our brothers and sisters but we are not a self-centered nation for the most part or as individuals, and that would demonstrate clearly in the early days of hiv/aids here and so i'm a very optimistic we can if we are carefully and do it well and do it right achieve what we need to do and grasp this moment of history. >> i share the same hopes and concerns. and i have two more. one is particularly every single day that another person who has been diagnosed or is living with hiv is able to lift their head in dignity and come out disclosed, share with their

concerns are, shared with their experiences are and bring others along with them the nei we are going to continue to link up with people who are experiencing the brought defeat the brunt of the of the democrats folks looking for the solution. they give me hope every single day. the second thing i think is that within my organization for example we've never not located hiv and the larger framework of human life, and that we know that for people who are most impacted or vulnerable they are also experiencing some of the worst human-rights oppression whether it is coming from violence or poverty or disenfranchisement, no adequate housing more dignified and come to support them and their family and that because we now have moved a little bit further down their road with the affordable care act, which understanding maybe we could agree that it is a human right that it will be

integrated into the much larger framework and effort to make sure health is treated in dignity and everyone has access to it and it is an exceptional issue only for a certain number of people i think that is where the hope lies when we realize that respected and for the resources responding to that we are going to see the end a lot sooner. >> i think to underscore people that are going to make the difference i think more importantly is the conquer generation that there are so many trail blazers back in my day but there are so many people in this audience and who are worked with now who were not around when the epidemic started and are taking up the mantle who are not living with hiv better still fighting for those people and i've been fighting for all my life and i think that is the biggest hope for me because no matter what, we have to continue

fighting this as long as we have to fight this we have got a new generation that is taking up that mantle. >> i want to remind folks if they would like to ask a question coming to the microphone and if you want to address it to one of the panelists, let us know otherwise we will take it. >> thank you. nearly 20 years ago i didn't know i would be working at hhs, but i am now and i have two special heroes, dr. fauci and my son. what connects the dots and you will see that we are part of the story today. there was a time 20 years ago i saw my son would be a piece of the quilt.

it is because dr. fauci was his first dr. and he was a part of the experimental treatment at the nih that he is living today, that he is in this audience. johnston, d want to stand up? [applause] justin, dr. fauci, has gone on to save many as you have. he's in the medical field treating individuals with hiv/aids. during those days of his treatment in the hospital i was the mother to many young men whose partners rejected them whose parents did not know, and by thank all of you for the tremendous work you have done, and especially for my wonderful

son. [applause] >> good morning everyone. i'm a deputy editor at pulp magazine and happen to be a person with aids, hiv, not aids yet. as a person living with hiv, i've always been helpful for the cure. i've been waiting for 30 years. all i hear a lot of good news and i would like to hear how hopeful you are. >> vary. [applause] [laughter] >> how much chance to be had for a cure in the near term? >> when you talk about a cure in the stage of scientific discovery to even determine if that is feasible, and we are encouraging by requests for

application and putting founding into different streams to get people to think of innovative ways to do that because the drugs we have our spectacular suppressing the virus but they don't get rid of the virus that hides in the reserve for. the other approaches six functional pure to read another words to suppress the violence and get the reservoir violence small enough that by any number of means either by boosting the body's immune response or another mechanism yet to be determined that you could stop therapy and the virus won't rebound back so there would be would call a functional tours. to be honest, i don't know how long that is going to take because we are in a phase of what we call discovery of mechanisms of how we can do that as opposed to implementing, we know we can stop the replication of the virus, we will get better

drugs, we have great drugs now but it's a scientific challenge whether or not we are going to be able to relate to our. so that's the honest answer. we are going to try really hard to do that. so hang in there and maybe you will be the one to get that medication and get out of your browser for. >> a couple things and that is one of the greatest opportunity that we have in front of us are the structural interventions out there including the affordable care act and the strategy and so, if i can allow myself to redefine the definition of cure, one of the goals of the strategy is to look at how we reduce infections and create the care we now both the size of internment and there are opportunities to work at eliminating the and permit as much as possible so we can get to a different type of your in the sense we can have communities not worried about

hiv as they have been in the past. so there's also ways we need to be looking at this from the standpoint of not just the science but also what are the policy opportunities in front of us that could actually allow us to get to that point. >> good morning and thank each of you for what you've done individually and collectively. the racial and ethnic health disparities coalition and african-american health alliance. knowing that one size does not fit all what has your professional judgment really needs to be done to better address the academic and blacks and hispanics among the hardest to reach, and more at risk than i think hardest to reach a. >> i'm going to start from a community perspective.

bennati in my earlier comments set of piteously diluted to i dream more than magic and it's not facetious at all. i am dead serious about the fact that in our community, our leadership, the leadership that not just the hiv eight leadership many of us look to and work with but our community leadership and civil rights leaders, our political leaders, education leaders, when those folks are celebrity, the people will listen to and then go and get the information and fisa and treatment from our medical and social service providers that when our whole community embraces this epidemic and response to it very much in the same way they will respond to when a tv show gets taken off or when one of pastor has to settle

some sort of lawsuit because of some salacious stuff he's been involved in and then they get all of in arms about that. when we begin to get on television and demand what is right for us, with us, by us, then that is when we are going to see a trickling down and a trickling off of the exchange, the incident, and also the lack of services available to us in our community. we will be able to address that but without the proper leadership and a community that will embrace that leadership idea and implementation of the programs and policies we need it for ourselves we are going to stay way behind in this epidemic. once we get in greece and realize this is an emergency, it is an urgency, and that we don't look at africa to be the only one who are coming together and solving african problems with

african solutions. it's going to be black and brown people using black and brown solutions to solve our problem in the country. and until then, we are going to be looking for someone else to come and save us and it is never going to work. >> beebee i will let a couple of -- [applause] a couple more points and as greater access to treatment and we know the impact the treatment has on prevention, i think of things we've already talked about with a greater access to the tools available to the extent the community gets access and demands access that will be helpful but i also think that not only is it important that there is leadership coming out and claiming of this as an issue, but also the willingness

to talk about the issues i related to hiv, you cannot talk about hiv in the aggregate american community about homosexual the and we don't want to talk about homosexual become a we don't want to pretend it exists. young african-american and hispanic and gay men are the ones who are disproportionately at risk. we've got to talk about what is happening to women and why they aren't in the situation where they feel they can negotiate safer sex, and that means talking to young girls about sex. we've got to be willing to talk about the issues related to it and talk about them openly and honestly and we are not willing to. and until we are, remember back in the day when we would say talk about the risk to groups

for hiv/aids, and we would say gay or black as if there were not gave black people sweet to be open and honest in the dialogue and until we do that, until we are willing to talk openly and honestly about sex and sexuality in the african-american community, then -- we have had the leaders getting up there and talking but, you know, they haven't been willing to say the words. >> there's also a scientific and medical response to that question also or is it only -- >> i think there is a science and medical in the sense that these are the same communities that are disproportionately impacted by other disease that have poor health services and access to health information. so it's no surprise kind of on the medical and the health side

that the same disparity is would be the case for hiv. but beyond that there are other issues as well. >> we have got time for one last question. >> i introduced us earlier. [laughter] my question is really about stigma and how it relates to especially the new modalities for prevention. we are really excited about becoming a demonstration site for groups, and i'm really excited about now that there are world class leaders talking about treatment is prevention, but treatment as prevention come with their own unique stigma that comes from providers as well as patients, community and so on. the risk compensation issues where providers say we shouldn't go down that road because then

it will be a free-for-all. everybody's not going to stop using condoms and so there's a solid research that shows the more you engage people in care the less risk they take along with getting treatment and prevention. and i appreciate your statement about homosexuality because we use the word stigma so much and have for 30 years that i think we sometimes forget what that means, and the majority of that is homophobia. and so, how do we deal with the new unique stigma issues around treatment and prevention, and how do we find leadership to address homophobia so we can start breaking down some of the barriers? my job would be to figure read how to break down those barriers, and there is a list of barriers i could the map almost every single one of them back, i just wanted to see what your

thoughts were about treatment of prevention and a stigma related to that. >> i think one of the opportunities people had and can do in terms of stigma and as long as you are a gauge to come out. the impact of that is tremendous in terms of being able to let someone know that you are gay. it's not easy to do but can have an impact how people can view what they might know being gay is. it's the same thing for living with hiv/aids that it takes a lot of courage but it's important that you come out about your status because you have to educate others that it's still there. those are important things i think can help but it takes a lot of courage and it's a burden in some respects because it impacts those who are the ones being stigmatized than most.

>> when i was in office i asked a lot of questions but ones that and lead me the most white is there so much stigma and africa? as if we don't have any purer. [laughter] and, you know, we all remember, and looking around a good chunk of the audience doesn't remember that in the early age of hiv/aids, the incredible stigma is where when i was a medical student down the road to va, people wouldn't touch hiv-positive patients. we had to sue surgeons and dentists to operate on hiv-positive people. as her mother pointed out, parents to send people, partners to send people on the misinformation how you got it was so bad the white house security people wearing rubber gloves. the stigma was remarkable, and we got through a lot of it, but

not all of it coming and you are living proof congratulations and thank you for when you are doing to serve through your life story. we got through a lot of it but not all of it. and just as in africa they are behind because they started leader are working through the issues but complicated and difficult and to me the solution comes back to what a lot of us talked about the back to the people in the community and ask them, talk with them about how they would get over the stigma, talk with them about how they will get over the stigma of treatment and prevention. what are they hearing. it's remarkable over and over again when we make these big proclamations globally or nationally and in the community what you're hearing is completely different than all the stuff we spent a whole bunch of money on. so going to the community and finding out first, well, again, they will figure out their problem. it's not easy. this is a journey, quote but we can do it and we know we can do

it because look where we were 25 years ago. if we keep moving along the continuum pathway and staying on it and listening to people, we can solve these problems. >> what could i also add that and just -- the question for me especially when we are talking about homophobia is not only centered with homophobia for homophobia, sexuality sake and if we draw back of the envelope it's really on sexuality. it to just be stickney because sexual is an issue we saw a lot of this week. i mean khayat -- [applause] it's funny and sad at the same time, and i talked to leaders about this all the time. you talk about god and the gifts of well, why else would he give

us sex as a means to get here if it wasn't a gift? in order to get life from anything, from the plant to the human that something has to engage, and to be able to normalize that conversation in such a way that there is no stigma of around section and sexuality that we all know we have to engage in it if we are going to appropriate or just enjoy ourselves we are going to stay around until tomorrow to get some at some point. [laughter] in iran? i mean, you know, it's not natural. [laughter] so, i want us to be clear about that because in all seriousness, young women who are sexually active are stigmatized. teen-agers they are

discriminated against. gay black men who are sexually active are stigmatized. mine having sex with one person because the socialization of month, david, not to be are stigmatized. people were still having sex at 85 and 90 are stigmatized. it doesn't matter the right and the recognition fingers as relationships. it matters hour not given the right and equal access and equal respect fact sex and salsas the stigma and until i can talk about my [inaudible]

which hi heels i need to put on today or what kind of earwax i've got coming out of my years until we can make it the same part of the same conversation it's going to continue and continue and continue. >> i think i have to make that the last word. [laughter] [applause] thank you the hit of the ira's

said today on capitol hill cutting $2 billion on this agency budget will decrease federal revenue in the long run and make the irs less effective.

setor f senator from montana? montana. >> i want to thank cementer revt for his comments.r reed f he's one of the leaders on thehe committee and i appreciate hiset comments. i want to set the record straight on a couple things. charness bernanke had plenty of information but not for banks and credit unions and that is what this amendment is about. the exception that is in the amendment we passed last year every regulator of the state levels of they cannot because market forces will determinestos where the customers fall. madam president, i'm glad we arn here to vote on the amendment wv

worked hard on.ni we are going to have an that ha opportunity to vote for an amendment that has been crafted the right way.go when they can to senator corker and by about a monthth ago the consequences of that amendment passed in the senate about a year ago.regulatis the amendment directed the research to issues limiting the debate for the sailors were. lit based on the law that the court intends to limit the costese control. even though the tra actual costf be higher.tions may the big wall street banks, theyl can handle that. they aren't happy but they can live with it. them mak the of plenty of schools to heli them make up the difference. the main street communicating send credit unions are ato d different story. these small guys who havedid not

nothing to do with the financiae banks thave come and these are the banks in montana, the folks i want to make sure have a fairs shake. they said how can i make this b protect the local banks andamt credit unions since the original amendment does not.study senator corker and i suggested y delay and then more legislative to fix any problems identified in the study. wi the senators who were here todad with me thought we could do better and we did and we could. afterco talking with ourtudy peo colleagues, wed work together to reduce a period down to it as i said earlier six months.illide at that tiifme the fed and other regulators will decide the rules can adequately present the smaln banks. i don't think that it devotee

knows that the agency signed book of rules consider our cuts comean as consumers wouldn't be harmed but the small issuesion, exception, those that apply tob, credit unions and community banks, if that exemption willord work the pending rules would move forward as past. and i would be the first persont in line to tell senator durbin he was right about the and two-tiered system.at the changes if the fed and other regulatorst find the changes must be made te ensure the rules don't include the cost or that small banks ane credit unions and consumers might be harmed you have to issue new rules within six yea, months. every two years the fed will have to tell usss in congress whether these rules are still working for the small banks ande credit unions. that's all we're asking for.ewus before the fed's rules getted, s implemented, let's make sure that we haveha a correct.

the good senator from alabama c, said yesterday this was truly as not a compromise but when youngk sit down with folks that think that you are on the wrong tracko and you worked together to try mefind a middle ground, to that is the definition of compromise. a other changes have been made --o other charges i should say havea been made about this amendment, and i would like to take a moment toso discuss those. some say it is in favor of the big bank. it's not. only in fact this amendment creates s problem that only affects the community banks to read illini said yesterday he crafted this amendment with awareness a majoa reduction interchange fees' kill would kill the small banks andne credit unions.nks and cret union no one denies the small banks ae and credit unions would be c harmed if they are forced into a iestem that can only charge 12 n

cents pers transaction. no one denies that. this is why senator durbin trier to establish a two-tieredroposa system. under his proposal, the big strn banks, big banks, while st. banks could charge one great ld well as a cost perdit union u transaction.ntinue to the small banks, community t percentage, 44% on average.plan. tet there is a big flaw in theds plan. the two-tiered system simply will not work. let me repeat that. what t it simply will not work and ie didn't make that up. here's what the chairman of the it's possible the remarks willwe they wouldn't be able to issuehe for a different size.

exemption will not be effective that was ben bernanke who said u that.tionill he went on to say because the bd exemption will not be effective, small banks could be hurt or even fail. said- "th hurting community banks and requiring them to increase the fees that they charge for accounts is much greater than any tiny benefit that the retail customer may get." again, madam president, everyone agrees that if the fed rules go into effect, the small banks and credit unions will suffer because the exemption simply will not work. so today we can stop and double check to make sure that that does not happen or we can just flip a coin and hope for the best and watch as more small banks and credit unions fail. reducing consumer choice and reducing banking options,

especially as they currently exist in rural america. these small banks and credit unions are the ones who make the loans to small businesses in rural america, they are in places where folks are still willing to put their money. they are the ones who folks in montana still trust. they don't trust the big wall street banks. we probably won't lose to many banks in washington, d.c., or chicago, illinois, but we will in rural america. i don't want to see that happen. another good one that i've heard this week is the argument that the amendment will allow banks the amendment will allow banks the. >> specifically states the federal reserve and other regulators must look at the costeb associated with debit card transactions and program operations.

we also know how dangerous p it is 27 price for thento product without understanding the cost thatrodu goes into the product from home depot would never s allown the government to set theno, price of a garden hose only set on manufacturing.f w they charge for the cost of manufacturing, shipping, sto cking, someone to tell you what i'll it is in and the list goes on. likewise if we are regulating debit interchange fees we have to understand all costs associated with transactions and debit programs. when they voted last year on this amendment we thought we were voting to have the fed hotsider all costs over the reality is the interchange amendment limited the cost be included. some thought they could be. included and others were not.e n some technology costs were

included but others were not. the regulate this market we need to be fair. so the amendment directs the fed to determine what is reasonable and proportionate but gives the fed the discretion to look at all of the cost associated with debit transactions. that does not mean executive pay or special rewards programs. all costs and need to be justified. if they cannot be justified, they will not be considered. the fed has been very clear with me know executive pay, no bells or whistles. but this is the cost of running networks, a fraud, and other technical details are much better left to the fed than decided by the unitedbe states senate. finally madame president some say it hurts consumers but it does not propose someone who voted against

the walls jabilef awp, wrote part of a credit card reforman act and perform for the bill, i can tell you if it was bad for consumers i would not offer it. but it is for the day issues that of consumer concern. it doesn't require anyone to look at the impact of interchange fee regulations on consumers. they are out of the pitcher. i am not aware of any specific plans by any retailers to lower prices of customer rebates and one large box storer with a company executive meeting e proposal to lowered interchange fees is a wer $35 million windfall. if i was a shareholder that sou does not sound good to me because a customer is not clear how i would benefit.

i am understand some ways the amendment would go further to include additional consumer oriented agencies house will conductpy t a study program would be happy to work with those senators to see how we could best protect consumers but the only way that it is going to happen is to get adopted today other bias rules go into effect no matter what the conservative think. >> we have the opportunity to address the unintended consequence of the durbin amendment and make no mistake those unintended consequences will be felt all over america and not for the better. those that think theot two-tier system will workere from another regulator of there will tell you that it will. ame those that tell you that the durbin amendment has the

exemption for community banks under $10 billion and credit unions if they think that would work, another regulator out there that will tell you use to m implement because of free market system willes drive it to the lowest price and that is the way it is. i am saying let's slowdown and make sure we get the right. if we create regulations was to have fair and consistent and not try to solve one problem and create three others. and also was not take shots of those who are not part of it. that is all i am asking andgi also for my colleagues to support this bill. it. >> senator tester amendment

failed to get the 60 votes needed prevent the debate continues on economic opponent program legislation to marvell. california's senator boxer and senator cardin talked about the debt ceiling on the senate floor. >> mr. president let the games begin. that is what is going on around here. i have full respect for my colleagues and you can tell from the tone of senator paul that he finds it amusing he is offering a clean debt ceiling increase he is offering and a an amendment he votes against her he knows his discussions with the president and vice president and in discussions with a gain of 62 try to fake keiraix c it is outrageous. i will tell you why.nder way of the underlying bill

thatel you have been very helpful with the economic the road map revitalization act which will reauthorize a i very importantn program that has been in place in this country since 1965. that was passed when george w. bush was president and passes the senate unanimously without all of these amendments that are going nowhere. there is 27 amendments as of last night and probably many more now and we know the game. we play it was before when senator andrew stood rye wasn standing to get a small business both through here which would have created thousands of jobs in this nation. but here we are. we have a bill that came out of the committee with a

strong vote to we had one dissent. senator inhofe is my primary co-sponsor. over 50 years this economic development administration has created jobs has spurred growth inth economically was hard-hit communities.e're we know the struggles we're having coming at of the greatest recession since the great depression and third try want to remind people that when president obama took over in this country was bleeding almost 1 million jobs per month. now we're getting back on our feet. the auto industry back on its feet. manufacturing back on its feet.acwe h and it is too slow. we have to do more. once in awhile we get the opportunity to work with small businesses and the

private sector and local government and nonprofit organizations to bring jobs and important work to our committees and this is one way.mmer with one arm of the chamber of commerce writing yesterday saying halla important this work is. do you have a question? >> this pacific leadership said service has of the abell partner so with cedar wapids, mob of alabama, ne orleans book ever time come r inat minneapolis, a new work, and many others signed by the executive director of the business leaders of center of the u.s. chamber of commerce.

this is a bill everybody was big gains -- games are being played for the fun of it to stop us from doing our job what is the number one job? to create jobs. what is the afl-cio said? business and labor. to assist economically troubled low-income communities with limited opportunities by putting the investment to good new-line use with industrial development propose signedci by a william daniel, director of government affairs department afl-cio. why is business and labor supporting thisy bill?

why do they want us to stop the games and pass the bill? because they want jobs for businesses and businesses want to the work.t let's take a look at other people who are supporting in addition to the chambers of commerce and others. the american public works assn tata when national association for counties and i was a supervisor who belong to that many years ago. if you run bipartisanship go to that. democrats, republicans, inde pendents liberals and moderates and conservatives.re they all come together because. >> what we have to face a 700 page amendment with

olympia snowe on the regulation that has not had one hearing of any committee and wooded even separate the important rules and regulations as public health and the environment. i am sure we cover together to make it wonderful. but instead it is offered in this bill 700 pages.enat >> will the senator yield for a question? >>er i will not yield at this time but when i have concluded. we have 700 page amendment that has been offered to the 40 page bill?

twenty-nine pages -- a 29 page bill to create tens of thousands of jobs and the first amendment is offered by my good friend, 700 pages, not one hearing and repeals projections for public health. i don't get it. there is only one thing i can get to with all of these amendments we have the debt ceiling that has nothing to do with this bill. this bill will create and come for taxpayers c because when jobs are created their people work they pay their fair share of taxes. this bill does not deserve to be treated this way. when it passed almost unanimously at of committee

and totally bipartisan and in place almost 50 years. but still that is where we are prepared a senator has the right to do what he or she wants. they could play games or have fun but do know what i care about? the people i represent. and mr. president, they need jobs. tricare about them whether kentucky come a california, at o.r. merrill lynch. we are united states. we should care about the people i just give up and play games. per is the little spark that creates economic activity in areas that are distressed c

and creates the jobs allever across the country prepare every dollar of investment as tracks the evolution liu some chart. when we vote for this bill bill, this is theutho authorization, not appropriation, we have authorized a 500 million to starkly in the last couple years although has been around 30250. every dollar as tracks seven -- $7 from the private sector. that is the fact it has been documented a congressional testimony that is the history of that m eda. people say how much it is here is what we know.arou >> is an average of $3,000 a

job. that is a good return. 220 and 500 jobs are created for every $1 million of investment. here is what we know. between 210,450,000 jobs were created everybody in the senate i think, although it could bed wrong has been asked what is the mosto important thing we have to do today? help to spur job creation in the private sector.co

and most of these are in cooperation with the privatetime sector and the sewer projects and water projects and i will give you some examples. >> says via authorizing this bill, how many would be created each year? it looks like it would create 200,000 jobs per year between 430,000 and 1 million jobs over the life of the bill. and i want to give you some examples. some examples because this is not rhetoric betteram t program in place since 1965. the city of dixon in my house stake g of $3 million for a water system that will

increase the city's water supply and storage capacity will overlooks the majorial impediment to to expand false wishes swim i canu n learn that as a county supervisor adequate sewer and negative a city was limited and if these are all necessary for job creation. this is expected to create 1,000 jobs and leverage 40 million with private investment so we have a $3 million investment toemeem improve the water system andoing leverage and $40 million. i call that a good deal forre our taxpayers a great for the american people to see jobs created. 1,000 good jobs created. that means 1,000 dads and

moms bringing home paychecks sen but what do we have here? the same thing senator andrew a had to put up with.we e amendment we even had a republican friend who would do away with the entire agency. unbelievable. but they will allow development of an additional 600 acres to an able continued growth at the center to mobile transportation hub. it is expected to create private investment that will be leveraged leveraged c leverage. >> host: we have to cut

spending i love when the republic tense was hurt -- lectured democrats onl felt the only party to balance the budget was thell democrats with bill clinton and in recent memory. we know how to do it and i don't need to years of oxygen -- socgen and doo did not say a word and pointed out on at credit card.yi >> i will not yield until i am finished. i said that before.ank thank you for asking. >> i have to reiterate so i don't lose my place. under bill clinton comment democrats balance the budget

and accretive surpluses and 23 million jobs.onfe george bush held a press conference and i saw it last night saying this belongs to the american people and did not say what he meant but then he went to work to put it on the credit card. my friends never once said i cannot raise the debt ceiling to pay the debt prevail voted buys afterul jurors bushel left, and got awful mess and the deficit the handed.'t

but the american people gett it. they don't buy it but theyappy understand it. they are not happy where weyo are and they shouldn't be but w we know when the problem started because you could try by those deficits and numbers come and they are in the books. i don't care whether it talks about paul revere ride or the deficit, that is history. i will say the deficits we have when we were in >> not then. >> but then we entered this situation the last couple years where jobs were

bleeding at 800,000 per month. i president obama did not take action. this recovery is tough the worst recession since the great depression. the this is what i know we can do if we work together will need tax cuts we can get new revenue to cut the fat and duplication said the laughter people who don't goend after their taxes then at at the end of the war, i would come o up with the newt trillion dollars pretty easily for ago.

>> the bill is likely in and do night and will dow everything we need to do now to leverage our dollars and attract private investment but no. we are facing on a host and i don't find enough money. i find it sad that we cannot come together. i have the city and the california in san-- silicon valley. san jose we got into the pvati program $3 million for the renovation and expansion and for which trading what did the you but we teach people to new skills to increase that capacity by 862 and expanded

access for the ged so they can get their diploma., h how to speak and how to read better. we taught them small business entreprenuership. this is what we arenew expanding. and this project will create 4900 jobs -- jobs but this was 1/1.ld a very.his i could tell you we arese continuing with this program. we have six regional officeshese and there were applications made for the grants but on2003

the west coast to prove some points, eda invested 1.8 million into the consumption of water andia. energy incubator tammet if you don't know that is where we can disclose thend vegetables and they are suffering and struggling. 2003, according to the eda incubator has housed more than 15 i entrepreneurs and they have over 70 million of private capital to create the jobs. one pliant eight to have more than 300 square feet but look what happens. that small investment attracted they accused h

leverage further you're not the a boat-- boeing company in order to reduce manufacturing jobs say and fess it is at 2 million to serve the commercial real -- but the high-tech am i sciences were 2,500 jobs but in the midwest talked-about this yesterday, i do this minnesota coming-of-age is somethingra horrific 3.5 million matched buy us to3 mi the grand and its crew from a hand focus 921,000.

this incubator now believes the corporation which is the largest share of thatabou aviation market. but we are talking about this plant a eighth seed but they it tracks by over -- nemours say. from the nonprofit and at the end of the day what have we done? it hasra grown and by the wayas you'll be shocked to know it was authorized the same amount in 1965. >>hy does that make you happy? 500 billion. so the fact this is not program that has grown and grown which